[unreadable] The overall goal of the proposed study is to assess the impact of programs of mother-to-child HIV transmission prevention on non-HIV specific antenatal care, using syphilis testing and treatment as the indicator of care quality. Many barriers to effective syphilis screening in antenatal care abound. The specific aims of the study are: Aim 1, To critically assess the global experience in antenatal syphilis screening in developing countries; Aim 2, To assess and compare documented syphilis screening and treatment among antenatal attendees in several clinics prior to and after infusion of health systems adjustments via research as compared to clinics not participating in research in Lusaka, Zambia. Aim 3. To assess and compare documented syphilis screening and treatment among antenatal attendees in several clinics prior to and after infusion of service delivery programs as compared to clinics not participating in service delivery in Lusaka, Zambia. Antenatal care as an entry point to prevent congenital syphilis is available, but not always effectively utilized as a health system component. There is sufficient information to control congenital syphilis, but due to systems failures, calls for new approaches to control this STI as an international health priority exist. New arguments for research may be revealed by the results of this study. [unreadable] [unreadable]